Provider Demographics
NPI:1427060920
Name:PHAM, CHRISTIAN ALEXANDER (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:ALEXANDER
Last Name:PHAM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6827 CAMP BULLIS RD STE 302
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-1730
Mailing Address - Country:US
Mailing Address - Phone:210-538-7500
Mailing Address - Fax:210-569-7750
Practice Address - Street 1:6827 CAMP BULLIS RD STE 302
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78256-1730
Practice Address - Country:US
Practice Address - Phone:210-538-7500
Practice Address - Fax:210-569-7750
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV53421223G0001X
CA552971223G0001X
MA212581223G0001X
TX327941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice